Document Detail

Two different reentrant circuits of ventricular tachycardia in a patient with an extensive anterior infarction: evaluation using electrical catheter ablation techniques.
MedLine Citation:
PMID:  1282247     Owner:  NLM     Status:  MEDLINE    
Two morphologically distinct sustained ventricular tachycardias were initiated by programmed stimulation during attempted catheter ablation in a patient with an old anterior myocardial infarction. Right bundle branch block configuration of ventricular tachycardia, which was identical to the spontaneously occurring tachycardia, was initiated and displayed fragmented mid-diastolic potential at the apicolateral left ventricular site. Evidence of a critical slow conduction area was observed during delivery of electrical stimuli to this area. Following a 150-joule electrical shock delivered to this area, right bundle branch block pattern of ventricular tachycardia was no longer inducible but a new sustained monomorphic ventricular tachycardia with left bundle branch block pattern was initiated. The mid-diastolic fragmented activity at the ablation site became electrical activation of bystander area that was not participating in the left bundle branch block type of the ventricular tachycardia circuit. The critical slow conduction area was identified at the apicoseptal left ventricular site that was separated more than 5 cm from the ablation site. We speculate that two morphologically distinct sustained monomorphic ventricular tachycardias may be due to two different reentrant circuits and not the different expression of the same circuit.
A Fujiki; M Tani; K Mizumaki; S Sasayama; Y Aizawa
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  15     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1992 Dec 
Date Detail:
Created Date:  1993-02-02     Completed Date:  1993-02-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2255-62     Citation Subset:  IM    
Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Japan.
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MeSH Terms
Bundle-Branch Block / physiopathology
Cardiac Pacing, Artificial
Catheter Ablation*
Heart Conduction System / physiopathology*
Myocardial Infarction / physiopathology*
Tachycardia, Ventricular / diagnosis,  physiopathology*,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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